Pilgrim Nanlesta A, Ahmed Saifuddin, Gray Ronald H, Sekasanvu Joseph, Lutalo Tom, Nalugoda Fred, Serwadda David, Wawer Maria J
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Rakai Health Sciences Program, Uganda Virus Research Institute, Entebbe.
Vulnerable Child Youth Stud. 2014 Jul 1;9(3):193-205. doi: 10.1080/17450128.2013.842027.
This study assessed the association between household family structure and early sexual debut among adolescent girls, ages 15-19, in rural Rakai District, Uganda. Early sexual debut is associated with detrimental physical, emotional and social outcomes, including increased risk of HIV. However, research on the family's role on adolescents' sexual risk behaviors in sub-Sahara Africa has been minimal and rarely takes into account the varying family structures within which African adolescents develop. Using six rounds of survey data (2001-2008) from the Rakai Community Cohort Study, unmarried adolescent girls (n=1940) aged 15-17 at their baseline survey, were followed until age 19. Parametric survival models showed that compared to adolescent girls living with both biological parents, girls who headed their own household and girls living with step-fathers, grandparents, siblings, or other relatives had significantly higher hazards of early sexual debut before age 16. Adolescent girls were significantly more likely to debut sexually if neither parent resided in the household, either due to death or other reasons. In addition, absence of the living biological father from the home was associated with higher risk of sexual debut, regardless of the biological mother's presence in the home. Our study's findings suggest that family structure is important to adolescent girls' sexual behavior. There is need for research to understand the underlying processes, interactions and dynamics of both low and high risk family structures in order to devise and strategically target interventions targeted for specific types of family structures.
本研究评估了乌干达拉凯区农村地区15至19岁少女的家庭结构与初次性行为过早之间的关联。初次性行为过早与有害的身体、情感和社会后果相关，包括感染艾滋病毒风险增加。然而，关于撒哈拉以南非洲地区家庭在青少年性风险行为中作用的研究极少，且很少考虑到非洲青少年成长所处的不同家庭结构。利用拉凯社区队列研究的六轮调查数据（2001 - 2008年），对在基线调查时年龄为15至17岁的未婚少女（n = 1940）进行追踪，直至她们年满19岁。参数生存模型显示，与与亲生父母双方同住的少女相比，自己当家的少女以及与继父、祖父母、兄弟姐妹或其他亲属同住的少女在16岁之前初次性行为过早的风险显著更高。如果父母均因死亡或其他原因不住在同一家庭，少女初次性行为过早的可能性显著增加。此外，无论生母是否在家，家中亲生父亲不在家都与初次性行为过早的风险较高相关。我们的研究结果表明，家庭结构对少女的性行为很重要。有必要开展研究，以了解低风险和高风险家庭结构的潜在过程、相互作用和动态，以便设计并针对性地实施针对特定类型家庭结构的干预措施。
